Massive Six-Figure Fine Leveled Against ACE American; North Carolina Workers’ Compensation Analysts Probe the Details
Many high profile North Carolina workers’ compensation cases have major interstate elements. A recent case filed by the Texas Insurance Department’s Division of Workers’ Compensation demonstrates how interconnected states like North Carolina, Texas, and Pennsylvania can be when it comes to workers’ comp claims and insurance disputes.
A Philadelphia-based company called ACE American Insurance Company was fined $221,000 for failing to pay key medical costs and failing to comply with the Texas Workers’ Comp Commissioner’s rulings. According to local sources, ACE had to pay a $74,000 fine pursuant to the company’s failure to respond to preauthorization requests and failure to pay for certain key treatments, services, and emergency care. In a second case, the insurance company paid out $147,000 pursuant to its failure to pay indemnity and medical benefits and failure to comply with the Texas Commissioner’s orders. ACE also did not pay medical bills according to Texas’ medical fee guidelines.
While this kind of case is not exactly novel – insurance companies have been known to try every tactic and strategy in the book to get out of paying North Carolina workers’ compensation claims – the story does illustrate the truly interstate ramifications of workers’ comp disputes.
Here you have a Philadelphia-based company dealing with allegations drawn up by the Texas Workers’ Comp Commissioner. Although states do make independent decisions regarding their workers’ comp programs, this case illustrates the essential interconnectedness of the US workers’ comp systems. National and even transnational players, like insurance companies, funds, and big businesses, often get deeply embroiled in state-specific litigation.
Fortunately, most workers’ comp claimants don’t have to worry about these highly technical ramifications. If you have been recently injured at work – or if you know someone who has come down with an occupational disease, such as bronchitis or repetitive stress injury, from work related activities – you want a simple, clear and precise strategy to get your benefits as quickly as possible and reboot both your health and your career.
Talk to an experienced North Carolina workers’ compensation law firm to develop and execute a sound plan of action to get the help you need.
More Web Resources:
Texas Insurance Department’s Division of Workers’ Compensation
